Question

In this case study, you will help the patient achieve a healthy, high fiber (38g/d) meal plan. There are three parts to this case study.

Part 2: Define and assess the recommended diet based on current guidelines from the textbook and the DGA

Case: Jim is a 47-year-old, Hispanic male recently diagnosed with diverticulosis. Jim is 5’ 10” tall, moderately active, and weighs 190 pounds. Jim has been instructed to increase the fiber in his diet to 38 grams per day. Jim is single, does his own shopping and cooking. He works long hours and rarely eats out. Below is a typical day’s intake for Jim. He reports liking most foods but tends to eat a very monotonous diet due to time restraints and ease of preparation.

Use the following resources to assist you in planning: For the fiber content of foods: Krause: APPENDIX 35. Nutritional facts on a high-fiber diet (p. 1049) 2015 DGA, Appendix 13. Food Sources of Dietary Fiber https://health.gov/dietaryguidelines/2015/guidelines/appendix-13/ Nutrient Profiles for Food Groups and Subgroups in the 2015 USDA Food Patterns https://www.cnpp.usda.gov/sites/default/files/usda_food_patterns/NutrientProfiles.pdf For assigning food to the appropriate DGA Food Group 2015 DGA Chapter 1- Key Elements of Healthy Eating Patterns) https://health.gov/dietaryguidelines/2015/guidelines/chapter-1/

Part Two: Define and assess the patient’s recommended diet (what his diet should be)

Complete the chart below:

Jim’s daily caloric needs can be found using the DGA chart from Table A2-1 (Appendix A). https://health.gov/dietaryguidelines/2015/guidelines/appendix-2/

Jim’s recommended intake (by food group) using the Healthy US-Style Meal Plan can be found in Table A3 (Appendix A) https://health.gov/dietaryguidelines/2015/guidelines/appendix-3/

The approximate fiber content of this new pattern can be found in the ‘Nutrient Profiles for Food Groups and Subgroups in the 2015 USDA Food Patterns’. https://www.cnpp.usda.gov/sites/default/files/usda_food_patterns/NutrientProfiles.pdf

This is the DGA Recommendation for Jim:

US-Style Plan for __XXX____ Kcal		Fiber * fiber content using averages from the CNPP site, text, or other USDA source
Food Group	Recommended Servings/d	g/d
Vegetables
Fruits
Grains
Dairy
Protein Foods
Oils
Other
	Total Fiber

1. How does this new, recommended pattern of intake compare with Jim’s original diet?

_______________________________________________________________

_______________________________________________________________

Answer 1

Dietary guidelines for Americans is science-based advice for Americans to promote health and to reduce the risk for major chronic diseases through diet and physical activity; updated every 5 years.

Four directives goals:

1. reduce the incidence and prevalence of overweight and obesity by reducing Calorie intake and increasing physical activity
2.shift food patterns to a more plant-based diet
3. reduce the intake of foods devoid of nutrients and excess in sodium and Calories from solid fat, added sugars and refined grains
*Diverticulosis is a condition where outpouching of the wall of the bowel. Diverticulosis typically occurs at sigmoid colon.

-Prevalence of diverticulosis :

• increases 5% with age under 40
• increases 65% over 85

-Cause of diverticulosis :

low fibre, low residue diet which produces high propulsion pressures.

-Treatment :

• Patient education
• High fibre diet
• Increased water intake

Part 1:

Define and assess the recommended diet based on current guidelines from the textbook and the DGA

In the present scenario, Mr.Jim is a 47-year-old, Hispanic male recently diagnosed with diverticulosis. Jim is 5’ 10” tall, moderately active, and weighs 190 pounds. Jim has been instructed to increase the fibre in his diet to 38 grams per day. Jim is single, does his own shopping and cooking. He works long hours and rarely eats out.

According to DGA, Consume a healthy eating pattern that accounts for all foods and beverages within an appropriate calorie level.

A healthy eating pattern includes:

• A variety of vegetables from all of the subgroups—dark green, red and orange, legumes (beans and peas), starchy, and other
• Fruits, especially whole fruits
• Grains, at least half of which are whole grains
• Fat-free or low-fat dairy, including milk, yoghurt, cheese, and/or fortified soy beverages
• A variety of protein foods, including seafood, lean meats and poultry, eggs, legumes (beans and peas), and nuts, seeds, and soy products
• Oils

A healthy eating pattern limits:

• Saturated fats and trans fats, added sugars, and sodium

These components are of particular public health concern in the United States, and the specified limits can help individuals achieve healthy eating patterns within calorie limits:

• Consume less than 10 per cent of calories per day from added sugars
• Consume less than 10 per cent of calories per day from saturated fats
• Consume less than 2,300 milligrams (mg) per day of sodium
• If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and up to two drinks per day for men—and only by adults of legal drinking age.
• Choose a healthy eating pattern at an appropriate calorie level with high fibre content that helps to achieve and maintain healthy body weight, support nutrient adequacy

Part 2:

US-Style Plan for __XXX____ Kcal

Fibre * fibre content using averages from the CNPP site, text, or other USDA source

Food Group	Recommended Servings/d	g/d
Vegetables	Potato (medium), baked, boiled or steamed, skin on	4.6g
Fruits	Pear (medium), with skin, Strawberries, 1/3 punnet	5.1g 2.1g
Grains	Rolled oats or quick oats, 50 g raw - 1 serve, Weet Bix, 2 biscuits, Bread, Burgen rye, 2 slice All Bran muesli, 45g; 1 serve Lentils, half cup cooked	4.7g 3.3g 6.0 6.1 5g
Dairy	Cow milk,1 glass	0.0
Protein Foods	Potato medium, steamed
Oils	Olive oil,1tbsp
Others	Potato chips plain 30g	1.0g
	Total Fibre	38g

1. In the present scenario, Mr Jim Jim is a 47-year-old, Hispanic male recently diagnosed with diverticulosis. In his followed original diet is composed of less fibre and high sugary diet with alcohol.

He is a moderately active man with consuming beer adverse this condition.

Here recommended a high fibre and high protein diet to manage the diverticulosis. It helps to prevent or avoid constipation and helping to ease passage of stools with less strain.